Like many young men, John Byrne has concerns about condoms. He struggles with them and fears one might break. But he also worries about HIV.
So he was intrigued when a friend told him about an HIV prevention strategy called PrEP (pre-exposure prophylaxis), which involves taking one daily pill of the antiviral drug Truvada to block the virus from infecting the body.
Byrne, 35, asked his doctor about it and started on PrEP in May 2015. He was so pleased that he formed the non-profit group Prevention Access Campaign working closely with the Florida Department of Health to promote PrEP among men and women in Broward and Miami-Dade counties.
As publisher of the successful Raw Story political news website, Byrne felt he had enough credibility to author a national article in Atlantic magazine encouraging PrEP for men who have sex with men (MSM).
“If you have something that will protect you 99 percent, why not use it?” Byrne says. “It’s so easy and effective. I have no side effects and it’s completely covered by insurance. I can envision taking this for the rest of my life unless a better protection comes along.”
Yes, he must still remember the caution to use condoms, because PrEP does not protect against other sexually transmitted diseases. He says that’s a small price to pay for the peace of mind of being protected against HIV.
Byrne has embraced PrEP so strongly in part because a growing number of his gay friends – especially younger men – do not routinely use condoms. They don’t like them, or feel they don’t need them, or choose to live with the risk of HIV despite decades of condom promotion.
“Behavioral change is not something you can force on people,” Byrne says. “To really combat HIV, we need another option than condoms.
“People have a misconception about their own risk. A lot of young people have that invincibility factor, feeling that ‘HIV will never happen to me.’ We need to offer them something,” Byrne says. “PrEP is a great option for women, too, a daily routine just like a birth control pill.”
He downplays the suggestion that PrEP undercuts condom use and will lead to a rise in other STDs. He says those who don’t use condoms while on PrEP would not have used them anyway.
A research study in February estimated that 40-45 percent of chlamydia and gonorrhea cases could be prevented if 40 percent of eligible MSM started on PrEP – not because of the medicine but because of STD tests at mandatory doctor visits every three to six months.
Byrne spends time meeting with doctors about PrEP, because he says many of them have misconceptions, too. The first doctor he asked about PrEP incorrectly told him it’s only suitable for people whose partners are living with HIV. He quickly changed doctors.
He now takes his PrEP pill alongside his vitamins and other medication.
“It’s prevention,” Byrne says. “This is just one more thing I do to live healthy. Prevention is a very responsible and empowering thing to do.”
Above content is provided by the Florida Department of Health in Broward County.